Erythropoietic Response and Outcomes in Kidney Disease and Type 2 Diabetes

This study assessed the relationship between initial responsiveness to darbepoetin alfa and outcomes in patients with chronic kidney disease and type 2 diabetes mellitus. A poor initial hematopoietic response was associated with an increased risk of death or cardiovascular events. Erythropoiesis-stimulating agents (ESAs) have been credited with a reduced need for red-cell transfusion and improved quality of life for patients with end-stage kidney disease who have severe anemia. 1 In patients with chronic kidney disease who do not require dialysis and have moderate anemia, the use of ESAs remains substantial, despite little evidence of benefit and increased concern that these agents may confer harm. 2 – 4 Trials comparing lower and higher hemoglobin targets have been interpreted to suggest that targeting of a lower hemoglobin range would be a safer approach in these patients, 2 , 5 , 6 leading to recommendations for continued use of . . .